Is There a Best Diet for PMOS (PCOS)?

There’s no single best diet for PMOS (polyendocrine metabolic ovarian syndrome, formerly known as PCOS). The 2023 international guideline finds no evidence that any one type of diet works better than another. What matters most is the overall quality of what you eat. That means meals built around fibre-rich carbohydrates, protein and healthy fats that keep your blood sugar steady, in a way you can stick with.

Search “best diet for PCOS” and you’ll be met with a wall of extremes, cut carbs, go keto, ditch gluten, try fasting. It’s loud, it’s contradictory, and most of it isn’t backed by evidence. The good news is that having PMOS doesn’t mean you need an extreme or restrictive eating plan. Here’s what the evidence actually says about eating well with PMOS, and how to put it into practice.

Quick facts:

• There’s no single “PMOS diet”, but the strongest evidence points to a Mediterranean-style, lower-glycaemic, higher-fibre way of eating that keeps your blood sugar steady.
• Insulin resistance sits at the heart of PMOS for many people, which is why food has such a direct effect on symptoms.
• Diet and lifestyle are first-line management in the 2023 international evidence-based guideline. Food can’t cure PMOS, but it can meaningfully ease symptoms.
• This isn’t only about weight. PMOS and insulin resistance affect people in smaller bodies too, and the same principles help regardless of your size.
• Balanced meals beat restrictive ones. Aim for the golden trio; good quality protein, healthy fats and a high-quality carbohydrate at each meal.

Why does what you eat matter so much with PMOS (PCOS)?

PMOS is a hormonal and metabolic condition, not just an ovary problem. That’s why nutrition has such an effect on how you feel.

For many people, PMOS is closely linked to insulin resistance. Insulin is the hormone that helps your body use glucose (sugar) from food for energy. With insulin resistance, your cells respond less well to insulin, so your body produces more of it to compensate. Higher insulin levels can stimulate your ovaries to produce more androgens, such as testosterone. That can contribute to irregular periods and ovulation, acne and excess hair growth. Insulin resistance can also make weight harder to manage.

Because what you eat directly affects your blood sugar and insulin, food is one of the most useful tools you have for managing PMOS. And because insulin resistance can happen at any body size, eating well with PMOS isn’t simply about weight loss.

If you are wondering whether your symptoms could be linked to PCOS, Hertility’s Advanced Hormone & Fertility Test can help build a clearer picture of your hormones, cycle and symptoms to help you understand what’s going on.

What is the best diet for PMOS (PCOS)?

No. There is no single diet that has been shown to be best for everyone with PMOS. The 2023 international guideline recommends general healthy eating principles and a way of eating that suits your preferences, rather than one particular diet. What matters most is the overall quality of your diet over time.

A Mediterranean-style diet is a useful framework because it naturally includes the foods that support metabolic and heart health: plenty of vegetables, fruit, wholegrains, beans and pulses, nuts, seeds, olive oil and oily fish. That matters in PMOS, which carries a higher long-term risk of type 2 diabetes and heart disease.

Lower-glycaemic eating may also help. The glycaemic index (GI) ranks carbohydrate foods by how quickly they raise your blood sugar. Lower-GI foods raise it more slowly and steadily. Some studies suggest lower-GI, higher-fibre diets can improve insulin resistance in people with PMOS, and some have linked them to more regular periods.

Think of these as helpful patterns rather than strict rules. You don’t need to follow a rigid meal plan. The common thread is choosing better-quality carbohydrates and keeping your blood sugar steadier.

How to make a PCOS-friendly meal?

Instead of focusing on what to cut out, start with what to add. A useful rule of thumb is to build each meal around three things: a fibre-rich carbohydrate, a source of protein and some healthy fat, with plenty of vegetables or fruit alongside.

For example:

• Porridge made with milk and topped with Greek yoghurt, berries and seeds.
• Eggs with avocado on wholegrain toast.
• Brown rice with chicken, tofu or beans, cooked in olive oil with plenty of vegetables.
• Lentil curry with rice and yoghurt.
• Salmon with new potatoes and greens.

Choose fibre-rich carbohydrates more often

Less-refined, higher-fibre carbohydrates are digested more slowly, so they raise your blood sugar more gradually and keep you fuller for longer. Good options include oats, quinoa, wholegrain or seeded bread, wholewheat pasta, brown rice, beans, lentils, chickpeas and potatoes with their skins on. Fibre also supports your gut health.

Glycaemic Index (GI)  is a ranking system, showing how quickly your blood sugar rises after eating different carbohydrates. Choosing mostly low or moderate GI foods which cause your blood sugar levels to rise slowly, can be useful to manage symptoms of PMOS. Very-low-carbohydrate and ketogenic diets have been studied in PMOS, but current guidelines don’t recommend one specific dietary pattern for everyone with the condition.

The rest of your meal matters too. Pairing carbohydrates with protein, fat and vegetables slows down how quickly your blood sugar rises. So you can still enjoy white bread, pasta or

rice. Choose higher-fibre versions more often, and think about the whole plate rather than whether one food is good or bad.

Include protein throughout the day

Protein makes meals more satisfying, helps manage your appetite and helps steady your blood sugar when you eat it with carbohydrates. Mix up your sources across eggs, fish, chicken, yoghurt, cottage cheese, tofu, tempeh, beans, lentils, nuts and seeds. Plant proteins such as beans, lentils and tofu are a particularly good choice because they provide fibre at the same time.

Protein is essential for making hormones and it may help lower androgens and raise SHBG (sex hormone-binding globulin), the protein that mops up excess testosterone and is often low in PMOS. 

Don’t be afraid of healthy fats

Unsaturated fats from extra-virgin olive oil, avocado, nuts like walnuts and almonds.and seeds support heart health and make meals more filling. Omega-3 fats from oily fish such as salmon, trout, mackerel and sardines may help improve insulin resistance and reduce inflammation in PMOS. NHS guidance is to eat at least two portions of fish a week, one of which should be oily.

Want help turning these principles into meals that fit your life? A Nutrition Consultation with a Registered Nutritionist or Dietitian can build a plan around your symptoms, tastes and routine.

What foods should you avoid with PMOS (PCOS)?

No foods need to be completely off-limits with PMOS. But it helps to cut back on foods and drinks that are high in added sugar or refined carbohydrates and low in fibre. These can raise your blood sugar quickly without keeping you full.

Sugary drinks are one of the most useful things to reduce, because they’re easy to drink a lot of and cause a fast rise in blood sugar. Many ultra-processed foods are also low in fibre and nutrients, so it’s worth relying on them less often.

That doesn’t mean chocolate, cake, crisps, pizza or a takeaway need to disappear from your life. Frequency matters more than perfection. An occasional treat won’t derail your hormones. Your overall eating pattern across weeks and months matters far more than any single meal.

A lot of online PMOS (PCOS) nutrition advice centres on cutting foods out. For most people, that isn’t necessary.

Do you need to stop eating sugar with PMOS (PCOS)?

You don’t need to cut out sugar completely. Reducing foods and drinks that are high in added sugar can help your metabolic health. But sugars also occur naturally in nutritious foods such as fruit and milk, and there’s room for something sweet in an otherwise balanced diet.

Sugar cravings are common with PMOS. Pairing something sweet with protein, fat or fibre can help slow down how quickly your blood sugar rises. Examples include dark chocolate with a handful of nuts, or cottage cheese or Greek yoghurt with a drizzle of honey. And if you have a pastry or a chocolate bar on its own now and then, don’t worry about it. Just enjoy it.

Should you go gluten-free if you have PMOS (PCOS)?

You don’t need to go gluten-free unless you have another reason to, such as coeliac disease. A gluten-free diet isn’t a treatment for PMOS. Cutting out gluten unnecessarily can make your diet more restrictive and lower in fibre-rich wholegrains. If gluten-containing foods regularly upset your digestion, speak to your GP or registered nutritionist or dietitian before cutting them out. Removing gluten before you’ve been tested can make coeliac disease harder to diagnose.

Is dairy bad for PMOS (PCOS)?

You don’t need to cut out dairy because you have PMOS. Milk, yoghurt and cheese provide protein alongside calcium, iodine and vitamin B12.

You may see claims online that dairy causes inflammation or acne. But research in healthy adults suggests dairy doesn’t increase markers of inflammation, and fermented dairy such as live yoghurt and kefir may even lower them. Studies of dairy and acne show a possible link in young people, but the evidence is mixed and hasn’t been studied specifically in PMOS. Unless you have an allergy or intolerance, or dairy clearly triggers your symptoms, there’s no good evidence for cutting it out.

Is keto diet good for PMOS (PCOS)?

Following a very low-carbohydrate or ketogenic diet is generally not recommended for PCOS due to low long-term sustainability and the risk of nutrient deficiencies. While short-term studies show keto can lower insulin, there is limited high-quality evidence supporting its long-term safety or benefits.

Instead, research indicates that a moderate approach, such as keeping carbohydrates around 40–45% of total calories can improve hormonal balance and ovulation without extreme restriction. It is therefore more important to focus on the overall quality and glycemic index of carbohydrates rather than cutting them out entirely.

Unnecessarily excluding gluten or healthy carbohydrate sources can leave you with below-optimal levels of fibre, folate, iron, and zinc, as key vitamins and minerals come from fruits, vegetables, whole grains, pulses, and beans.

Does losing weight help PMOS (PCOS)? 

PMOS affects people across the weight spectrum, and healthy lifestyle changes can improve health even in the absence of weight loss.

For some people losing weight may improve insulin sensitivity and some PMOS symptoms. The evidence shows that losing around 5–10% of your starting weight can improve metabolic, reproductive and psychological outcomes in PMOS, often enough to help restore more regular cycles. 

But weight loss should not be presented as the only treatment for PMOS and being told simply to “lose weight” without appropriate support isn’t good enough.

Current international PMOS guidance emphasises healthy lifestyle behaviours, individualised goals and the importance of recognising weight stigma in healthcare. Most importantly, nutrition advice should be individualised. A restrictive diet that damages your relationship with food isn’t automatically healthier simply because it results in weight loss.

Tips to help manage PMOS (PCOS)

The best lifestyle changes are the ones you can realistically fit into your life. What you eat is only one part of managing PMOS. A few other habits can make a real difference.

Physical activity. Regular activity improves insulin sensitivity, whatever your weight. UK guidelines recommend at least 150 minutes of moderate activity a week, such as brisk walking or cycling, plus strength exercises on at least two days. There’s no single best type of exercise. Walking, swimming, strength training and yoga all count. Choose what you enjoy and can keep doing.

Sleep. PMOS is linked with a higher risk of sleep problems, and poor sleep can affect your blood sugar and appetite. Aim for 7 to 9 hours a night, and keep a regular routine by going to bed and getting up at similar times. Try to switch off screens an hour before bed and keep your bedroom cool.

Stress and mental health. PMOS is also linked with higher rates of anxiety and depression. Stress-reducing habits such as walking outdoors, yoga, meditation or journaling can help. If you’re struggling, speak to your GP or a counsellor. Your mental health is as much a part of your PMOS care as your hormones.

What supplements to take for PMOS (PCOS)?

Supplements are one of the most asked-about, and most over-hyped, parts of PMOS management. A few, such as inositol, have some promising evidence, but none is a substitute for the eating pattern above. They work best as a considered addition to good nutrition, not a shortcut around it.

If you’re trying to conceive, everyone is advised to take folic acid, and vitamin D is recommended for most people in the UK. You may also need a specific supplement if a test shows you’re deficient in something. We’ve broken down the individual supplements, what the evidence actually says, sensible doses, and what to be cautious about  in our dedicated guide: supplements for PMOS (PCOS): what works and what doesn’t.

Always speak to your GP, pharmacist or a registered dietitian before starting a new supplement, particularly if you’re trying to conceive or take other medication.

Ready to understand your PMOS (PCOS) with Hertility?

PMOS looks different from person to person, so your nutritional needs may be different too.

Personalised support can be particularly useful if you’re managing insulin resistance, trying to conceive, struggling with your weight or relationship with food, following a restricted diet, or simply feeling overwhelmed by conflicting nutrition advice.

At Hertility, our women’s health specialist registered nutritionists and dietitians can help build a personalised plan around your symptoms, lifestyle, dietary preferences, fertility goals and nutritional needs.

In a Nutrition Consultation, our Registered Nutritionists and Dietitians, who specialise in women’s health and PMOS, will build a personalised plan around your symptoms, lifestyle, food preferences, fertility goals and nutritional needs.

Frequently Asked Questions

What is the best diet for PMOS (PCOS)? 
There’s no single best diet for PMOS. The 2023 international guideline recommends healthy, sustainable eating rather than one specific diet. A Mediterranean-style, lower-glycaemic pattern is a useful framework, built on vegetables, fruit, wholegrains, pulses, oily fish, olive oil and nuts, with fewer refined carbohydrates and sugary drinks.

Do I need to cut out carbs completely if i have PCOS ?
No. It’s the quality of your carbohydrates that matters, not cutting them out. Higher-fibre carbohydrates such as oats, wholegrains and pulses help keep your blood sugar steady, especially when eaten with protein and healthy fats. Very restrictive diets are hard to sustain and aren’t necessary.

I’m not overweight, does nutrition still matter for my PMOS?
Yes. Insulin resistance is common in PMOS, including in people in smaller bodies, and the same eating principles help regardless of your weight. The aim is steadier blood sugar and better metabolic health, not weight loss for its own sake.

What are the best foods to eat with PMOS?
There’s no single best food for PMOS. Focus on a varied diet with fibre-rich carbohydrates, vegetables, fruit, protein and healthy fats. Wholegrains, beans, lentils, nuts, seeds, eggs, oily fish, yoghurt and tofu can all be part of a PMOS-friendly diet.

What is a good breakfast for PMOS?
A good breakfast for PMOS combines protein, fibre and healthy fats to keep your blood sugar steady. Porridge with yoghurt, berries and seeds, or eggs with wholegrain toast and vegetables, are two simple options.

References

Kazemi, M. et al. (2020). Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Advances in Nutrition. https://doi.org/10.1093/advances/nmaa092

Juhász, A. et al. (2024). Ranking the dietary interventions by their effectiveness in the management of polycystic ovary syndrome: a systematic review and network meta-analysis. Reproductive Health. https://doi.org/10.1186/s12978-024-01758-5

Caretto, A. et al. (2026). Targeting Insulin Resistance Through Nutrition: Pathophysiological Insights and Dietary Interventions. Nutrients. https://doi.org/10.3390/nu18071119

Mei, S. et al. (2022). Mediterranean Diet Combined With a Low-Carbohydrate Dietary Pattern in the Treatment of Overweight Polycystic Ovary Syndrome Patients. Frontiers in Nutrition. https://doi.org/10.3389/fnut.2022.876620

Zhang, L. et al. (2025). Optimizing carbohydrate quality: a path to better health for women with PCOS. Frontiers in Nutrition. https://doi.org/10.3389/fnut.2025.1578459

Kazemi, M. et al. (2018). A Comparison of a Pulse-Based Diet and the Therapeutic Lifestyle Changes Diet in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Nutrients. https://doi.org/10.3390/nu10101387

Jeanes, Y.M. & Reeves, S. (2017). Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome. Nutrition Research Reviews. https://doi.org/10.1017/S0954422416000287

Fitz, V. et al. (2024). Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines. Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgad762

Greff, D. et al. (2023). Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reproductive Biology and Endocrinology. https://doi.org/10.1186/s12958-023-01055-z

British Dietetic Association (2022, under review). Polyendocrine metabolic ovarian syndrome (PMOS) and diet — Food Fact Sheet. https://www.bda.uk.com/resource/polycystic-ovary-syndrome-pcos-diet.html